None listed
Conditions
Brief summary
Screening for overweight during growth means that parents should receive appropriate feedback regarding the weight status of their child and that effective treatments are widely available for those identified as overweight. This may be particularly important in younger children where parents often do not recognise that a child is overweight. Our randomised controlled trial has two parts: feedback and treatment. The aim of part one is to determine whether feedback about a child's weight status delivered using motivational interviewing can improve parental acceptance of the health risks associated with overweight and increase engagement in lifestyle changes, relative to "usual" feedback. In part two, we want to determine whether a tailored family-based package that involves frequent nurse support and limited “expert” involvement can improve weight and other health outcomes in 4-8 year overweight children at two years, relative to “usual” care.
Interventions
MInT has a two-stage study design: 1) screening and feedback and 2) treatment.
1) Screening and feedback: 1500 children aged 4-8 years will attend well child health checks. Parents of children with body mass index (BMI) values less than the 85th percentile of age- and sex-specific reference norms (Center for Disease Control (CDC)) will be informed of their child's weight and will not participate further in the study. Children who are overweight (BMI greater than or equal to the 85th percentile,
MInT has a two-stage study design: 1) screening and feedback and 2) treatment. 1) Screening and feedback: 1500 children aged 4-8 years will attend well child health checks. Parents of children with body mass index (BMI) values less than the 85th percentile of age- and sex-specific reference norms (Center for Disease Control (CDC)) will be informed of their child's weight and will not participate further in the study. Children who are overweight (BMI greater than or equal to the 85th percentile, estimate 400) will be randomised to one of two feedback mechanisms: Business as Usual versus motivational interviewing (MI). Trained staff will interact with families to deliver the feedback in the appropriate manner. MI is a non-judgemental, empathetic style of counseling which encourages individuals (or families) to “buy into” changing behaviours. For those randomised to the Business as Usual feedback condition, the research nurse will discuss the results briefly with the families, using a report card which details the results. In the motivational interviewing condition, the same report card would be used but the nurse will use MI to discuss the BMI findings in a way that allows parents to explore their reactions to the information and what they might be able to do in response. Two weeks later they will be reinterviewed to assess their reactions to feedback (benefits, harm, perceived behaviour change). 2) Treatment: All 400 overweight children will be invited into a two-year family-based weight management programme. They will be randomised to one of two treatment conditions: usual care versus tailored treatment. Those in the usual care condition will meet once with a nurse to receive a single 30 minute session detailing general healthy eating and physical activity advice. Those in the tailored treatment condition will meet once with an expert team to develop goals and solutions that are family-based and tailored to each individual family. Each family will then meet regularly with their mentor who will assist them with their progress (using motivational interviewing where appropriate). Frequency of contact will decrease over two years from initially weekly to three-monthly.
Sponsors
University of Otago
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
4 Years to 8 Years
Healthy volunteers
Yes
Inclusion criteria
All children enrolled at local general practices or attending Paediatrics Outpatients will be invited to attend well child screening checks. Only those with BMI values greater than or equal to the 85th percentile (CDC) will be randomised to feedback and intervention conditions.
Exclusion criteria
Inability to participate in a behavioural intervention. On any medication known to affect body composition or growth. Not intending to reside in Dunedin for the next two years.
Outcome results
None listed